Workers Compensation Claims Examiner

Senior Workers' Compensation Claims ExaminerAcrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role is responsible for investigating claims, determining compensability, managing litigation, evaluating exposure, and developing claim resolution strategies while ensuring compliance with California workers' compensation laws and regulations.Candidates must have direct, hands-on experience handling California workers' compensation claims. An active California Adjuster Certification, experience handling self-insured claims through the California Office of Self-Insurance Plans (OSIP/SIP), or a Certified Workers' Compensation Professional (CWCP) designation is required.This is a fully remote position. Candidates must be able to support California-based claims and work business hours aligned with Mountain or Pacific Time zones.ResponsibilitiesIndependently manage a caseload of California workers' compensation claims from assignment through resolutionInvestigate claims, evaluate compensability, and determine appropriate claim handling strategiesReview coverage, liability, medical documentation, and claim exposure in accordance with California regulationsEstablish and manage reserves based on claim exposure and ongoing developmentsManage complex indemnity claims, including litigated files and settlement negotiationsCoordinate with defense counsel, medical providers, employers, and other stakeholders throughout the claims processMonitor claim progress, maintain accurate diaries, and ensure timely follow-up on all assigned filesCoordinate return-to-work efforts and support positive claim outcomesIdentify fraud, subrogation, and cost containment opportunities when appropriateMaintain complete, accurate, and timely documentation within the claims management systemProvide guidance and claim recommendations on complex files as neededPerform additional duties and projects as assignedRequirements5+ years of experience handling California workers' compensation claims requiredExperience managing indemnity claims requiredExperience handling litigated workers' compensation claims requiredCurrent California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation requiredStrong knowledge of California workers' compensation laws, regulations, and claims handling practicesExperience developing claim resolution strategies and negotiating settlementsAbility to independently manage complex claims with minimal supervisionStrong analytical, decision-making, and problem-solving skillsExcellent verbal and written communication skillsStrong organizational skills with the ability to manage multiple priorities in a remote environmentProficiency with Microsoft Office and claims management systemsEducation and LicensesHigh school diploma or equivalent requiredAdditional education beneficialCurrent California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation requiredPay Details:The base compensation range for this position is $95,000 - $110,000. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership.Why Join Us:At Acrisure, we're building more than a business, we're building a community where people can grow, thrive, and make an impact. Our benefits are designed to support every dimension of your life, from your health and finances to your family and future.Making a lasting impact on the communities it serves, Acrisure has pledged more than $22 million through its partnerships with Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan, UPMC Children's Hospital in Pittsburgh, Pennsylvania and Blythedale Children's Hospital in Valhalla, New York.Employee BenefitsWe also offer our employees a comprehensive suite of benefits and perks, including:Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.… and so much more!This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location.Acrisure is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting View email address on click.appcast.io candidates will be required to complete post-offer verification processes related to the role and in accordance with applicable laws.California Residents: Learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy.Recruitment Fraud: Please visit here to learn more about our Recruitment Fraud Notice.Welcome, your new opportunity awaits you.